Endoscope accessory

ABSTRACT

This invention generally relates to a method for performing an endoscopic procedure. According to some aspects of the invention, the method comprises placing an endoscope shaft within a body cavity at a desired examination point, the endoscope shaft having a proximal end, mid shaft and a distal end, the distal end terminating in an endoscope tip, wherein the endoscope tip is proximal to the desired examination point, positioning a segment of a longitudinally opened overtube over the endoscope mid shaft, wherein the overtube including a longitudinal reclosable seam along an entire length of the overtube, an inner surface, an outer surface, a proximal end and a distal end, a positioning ring adjacent the distal end on the outer surface, at least one sealing band on the inner surface, and an independently positionable occlusion catheter terminating in an asymmetrical occlusion balloon; at least one handle at the proximal end and on the outer surface for grasping and manipulation of the overtube within the body cavity. The method further comprises closing the seam of the segment of the overtube positioned over the endoscope mid shaft to form a longitudinally closed overtube and move the closed overtube over the endoscope shaft as guide within the body cavity and repeat the closing and moving till the overtube reaches the desired examination point, inflating the positioning ring to create a seal between the outer surface of the overtube and a body cavity proximal to the endoscope tip, wherein when inflated the positioning ring expanded asymmetrically around the overtube, inflating the at least one sealing band to create a seal between the internal surface of the overtube and endoscope shaft, passing the independently positionable occlusion catheter terminating in the asymmetrical occlusion balloon through a passageway along the overtube to enter the body cavity at the end of the overtube, manipulating the independently positionable occlusion catheter to a selected point within the body cavity distal to the endoscope tip, inflating the occlusion catheter balloon to create seal between the occlusion catheter balloon and the body cavity, and creating a sealed examination compartment between the positioning ring, the asymmetrical occlusion balloon and the sealing band surrounding the distal end of the endoscope shaft.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation-in-part of U.S. patent applicationSer. No. 15/338,194 filed Oct. 28, 2016, which is a continuation-in-partof U.S. patent application Ser. No. 14/575,509 filed Dec. 18, 2014 (U.S.Pat. No. 9,480,390 issued Nov. 1, 2016), which is a continuation-in-partof U.S. patent application Ser. No. 14/121,563 filed Sep. 18, 2014 (U.S.Pat. No. 9,993,137 issued Jun. 12, 2018), which is acontinuation-in-part of U.S. patent application Ser. No. 13/900,524filed May 22, 2013 (U.S. Pat. No. 9,521,945 issued Dec. 20, 2016), whichis a continuation-in-part of U.S. patent application Ser. No. 12/266,953filed Nov. 7, 2008 (U.S. Pat. No. 9,867,529 issued Jan. 16, 2018), thecontent of which is incorporated herein by reference in its entirety.

FIELD OF INVENTION

Some embodiments of the present invention relate generally to the fieldof endoscopy and, more particularly, to an endoscope accessory forimproving endoscopic examination of body organs, particularly thegastrointestinal tract.

BACKGROUND OF INVENTION

Endoscopy is a well-known procedure for examining internal organs. Theprocedure is performed under the guidance of an endoscope. Currentlyused fiber optic endoscopes include lenses mounted in a flexible tubethat relay an image from inside a body cavity for viewing by a physicianfor diagnosis or manipulation inside the body cavity.

In performing an endoscopy, it is common to insufflate (introduce airinto) the gastrointestinal tract in order to provide easiervisualization. This can cause bloating and discomfort to the patient or,in rare cases, severe abdominal pain.

More recently, echoendoscopy has been introduced. An echoendoscope (EUS)is a device that combines endoscopy and ultrasound to image thegastrointestinal wall and surrounding structures.

The ultrasound transducer is positioned at the distal tip of endoscope;the key components of the transducer are the piezoelectric crystals thatvibrate to produce ultrasonic waves. The ultrasonic waves travel throughthe gastrointestinal wall and beyond the visceral wall into thesurrounding organs. The reflection of these ultrasound waves is detectedby the same crystals at the transducer, and reconstruction of thesereflections can result in creating a real-time image of thegastrointestinal wall and its surrounding structures. The ultrasonicwave reflects from the surface of structures with different densitiesand can pass very well through fluid-containing and solid structures.Air, however, creates a barrier to ultrasonic wave passage and hampersthe obtaining of ultrasonic images.

Several attempts have been made to minimize the amount of interferingair between the transducer and the examining structure. The prior artteaches the use of balloons at the end of the endoscope that enclosesthe transducer and is filled with water to permit acoustic couplingbetween the transducer and the luminal wall or other gastrointestinalstructures. This is particularly helpful in the part of thegastrointestinal tract where the diameter of the lumen is small, and theinflated balloon makes good circumferential contact with the intestinalwall and thus creates a good acoustic coupling. In most parts of thegastrointestinal tract, however, the large diameter of the lumen and/orthe angle of the transducer in relation to the intestinal wall resultsin inadequate contact between the transducer balloon and the intestinalwall. Therefore, operators usually use water infusion to fill the regionof the gastrointestinal tract with water and create acoustic couplingbetween the transducer and the examined structures.

A significant shortcoming of this prior art is that it does not accountfor the fact that the gastrointestinal tract is not a closed region andthe infused water soon moves to other regions of the gastrointestinaltract. Infusion of significant amounts of water during the examinationcould result in untoward problems such as aspiration of the water intothe patient's airway or over-distention of the gastrointestinal tract.

Further advances in the prior art include two-balloon approaches forassisting the movement of the endoscope. However, these prior artdevices utilize the balloons only to secure and maintain positioning ofthe endoscope or to seal two separate anatomical structures from oneanother. To advance the endoscope, the balloons must be deflated andinflated in alternating order. Yet further attempts have taught the useof an overtube that consists of a device having a window near its distalend through which the endoscopic examination can be performed. Ashortcoming of this approach is that it limits the maneuverability ofthe endoscope and may create noise, thereby diminishing the accuracy ofa procedure.

There is a need, therefore, for an examination accessory for endoscopicexamination that creates an examination partition around the endoscopetip. Such a device can create an examination compartment proximal anddistal to the endoscope or ultrasound tip. The examination compartmentcan then be filled with air, water or could be thoroughly lavaged usingthe device. Such a device can further include balloons comprising atleast a positioning ring for maintaining the position of the endoscopeaccessory in an area to be examined and to seal the proximal end of theexamination partition independent of the endoscope tip and can alsoinclude an independently positionable occlusion balloon distal to thetip of the endoscope or echoendoscope for sealing the distal end of theexamination partition. There is a further need for such a device thatcan be advanced or retracted without the necessity of deflating andre-inflating the balloons, thereby creating a movable examinationcompartment. There is a further need for such a device that can beplaced on an endoscope shaft without the necessity of having to removethe endoscope from the body. Some embodiments of the present inventionprovide such a device.

SUMMARY OF THE INVENTION

Some embodiments of the present invention improve endoscopic examinationby enhancing and maintaining luminal view by deploying the proposeddevice. The endoscopic examination method comprises placing an endoscopeshaft within a body cavity at a desired examination point, the endoscopeshaft having a proximal end, mid-shaft and a distal end, the distal endterminating in an endoscope tip, wherein the endoscope tip is proximalto the desired examination point, positioning a segment of alongitudinally opened overtube over the endoscope mid-shaft, wherein theovertube including a longitudinal reclosable seam along an entire lengthof the overtube, an inner surface, an outer surface, a proximal end anda distal end, a positioning ring adjacent the distal end on the outersurface, at least one sealing band on the inner surface, and anindependently positionable occlusion catheter terminating in anasymmetrical occlusion balloon; at least one handle at the proximal endand on the outer surface for grasping and manipulation of the overtubewithin the body cavity. The method further comprises closing the seam ofthe segment of the overtube positioned over the endoscope mid shaft toform a longitudinally closed overtube and move the closed overtube overthe endoscope shaft as guide within the body cavity and repeat theclosing and moving till the overtube reaches the desired examinationpoint, inflating the positioning ring to create a seal between the outersurface of the overtube and a body cavity proximal to the endoscope tip,wherein when inflated the positioning ring expanded asymmetricallyaround the overtube, inflating the at least one sealing band to create aseal between the internal surface of the overtube and endoscope shaft,passing the independently positionable occlusion catheter terminating inthe asymmetrical occlusion balloon through a passageway along theovertube to enter the body cavity at the end of the overtube,manipulating the independently positionable occlusion catheter to aselected point within the body cavity distal to the endoscope tip,inflating the occlusion catheter balloon to create seal between theocclusion catheter balloon and the body cavity, and creating a sealedexamination compartment between the positioning ring, the asymmetricalocclusion balloon and the sealing band surrounding the distal end of theendoscope shaft.

the endoscopic device includes an overtube including a longitudinalreclosable seam along an entire length of the overtube, an innersurface, an outer surface, a proximal end and a distal end, apositioning ring adjacent the distal end on the outer surface, at leastone sealing band on the inner surface, an openable sheet having a firstedge and opposed to a second edge, each one of the first edge and thesecond edge further including a closure, the first edge closure, and thesecond edge closure coacting with one another to form an essentiallycylindrical overtube, wherein the longitudinal reclosable seam includesadhesive and release sheet, spaced magnets, magnet strings, a zipper,which are carried by longitudinal edge portions along the entire lengthof the longitudinal reclosable seam; at least one handle at the proximalend and on the outer surface for grasping and manipulation of theovertube within a body cavity.

The endoscopic device also includes an occlusion catheter located withina lumen of the overtube and terminating in an asymmetrical occlusionballoon, and an endoscope shaft located in the overtube and having aproximal end, a mid-shaft, and a distal end, wherein the distal endterminates in an endoscope tip.

Moreover, the endoscopic device includes at least one flexible elongatedsheet, sized to envelop a flexible endoscope or echoendoscope shaft andcan envelop the endoscope or echoendoscope shaft without the need toremove endoscope from the body; its opposed longitudinal edge portionscan coact to form a flexible overtube receiving there within theendoscope or echoendoscope shaft.

The longitudinal edges of the endoscope accessory can be supplied withan adhesive along its entire length for coacting with the opposed edgeportions to form a liquid-tight seam along the entire length of theovertube. The adhesive can be covered by a release sheet that can beremoved before adhering the two longitudinal end portions.

Alternative embodiments to using adhesive at the longitudinal edges ofthe endoscope accessory for creating the longitudinal seam can includeusing a plurality of spaced magnets or magnet strings on thelongitudinal edge portions of the endoscope accessory sheet that areattracting the other magnets interspersed on the other longitudinal edgeportion. To avoid activation of the magnets before placing the endoscopeshaft within the overtube, at least one longitudinal edge portion can besupplied with a longitudinal magnet cover. Both longitudinal edgeportions can be provided with a cover. The magnets can only coact withthe opposed longitudinal edge portion magnets when the magnet covers areremoved from the edge portion or portions.

The overtube can be provided with a handle on the external surface atthe proximal end of the overtube for grasping and manipulation of theovertube within the body cavity. The handle is also the hub where aplurality of external inflation tubes and an irrigation/drainage portcan connect to the overtube individually or in combination using adetachable multiple tube connection port. This can be used forconnection of the overtube to an inflation device, suction device,irrigation tube system or passage of therapeutic tools through theovertube.

The overtube can further include at least one inflatable positioningring on the external surface of the distal end portion of the flexibleovertube for securing the position of the overtube within the bodycavity. The inflated positioning ring can be asymmetric or eccentric inregard to the overtube. This allows a better sealing created by theinflatable positioning ring within the body cavity and also improves themaneuverability of the endoscope tip within the body cavity.

The overtube can further include at least one positioning ring inflationtube in communication with the inflatable positioning ring for inflatingor deflating the inflatable positioning ring.

The overtube can further include at least one inflatable sealing band onthe internal surface of the overtube at the distal end portion of theovertube for the creation of a seal around the endoscope shaft withinthe overtube. Alternatively, the inflatable sealing band can be replacedwith an elastomeric sealing bead on the internal surface of the flexibleovertube. The inflated sealing band can be eccentric to the overtube.This allows a better seal created by the inflatable sealing band overendoscope. The inflated sealing band seals the distal end of theovertube around the endoscope to prevent the leakage of fluid and gasfrom the distal end of the overtube into the lumen of the overtube.Alternatively, the sealing band can be positioned on the internalsurface of the overtube at the mid-portion, or proximal end portion ofthe overtube. Alternatively, there could be more than one sealing bandwithin the internal surface of the overtube.

The overtube can further include at least one sealing band inflationtube for inflating or deflating the inflatable sealing band/s.

The overtube can further include at least one catheter passageway, whichdefines a passageway for passing a catheter or other accessories, suchas biopsy forceps and other endoscopic accessories from the overtubeproximal end portion to the overtube distal end portion.

The endoscope accessory can also include at least one occlusion cathetercarried by the overtube through the catheter passageway, having a free,independently positionable distal end portion that terminates in aninflatable occlusion balloon.

The occlusion catheter can include at least one occlusion balloon tubefor inflating or deflating the inflatable occlusion balloon and at leastone a suction tube that terminates in a suction tip downstream of theocclusion balloon that facilitates injection of fluid or removal ofsecretions of body cavity distal to the occlusion balloon.

The endoscope accessory can also include at least oneirrigation/drainage port. The irrigation/drainage port can be situatedon the overtube handle and can include a closeable lid. Theirrigation/drainage port can allow a direct access to the lumen of theovertube. The irrigation/drainage port can be connected toirrigation/drainage tubes that can deliver water into or drain water outof the examination compartment in the gastrointestinal tract through thelumen of the overtube.

The overtube can further include at least one inflatable sealing band onthe internal surface of the overtube at the proximal end portion of theovertube, proximal to the irrigation/drainage port for the creation aseal around the endoscope shaft within the overtube. Alternatively, theinflatable sealing band can be replaced with an elastomeric sealing beadon the internal surface of the flexible overtube. The inflated sealingband can be eccentric to the overtube. This allows a better seal createdby the inflatable sealing band over the endoscope. The inflated sealingband seals the proximal end of the overtube around the endoscope toprevent the leakage of fluid and gas from the proximal end of theovertube. Therefore, the fluid and gas can be purged into or drainedfrom the lumen of the overtube through the irrigation/drainage portwhile the endoscope is still within the overtube without leakage of thefluid or gas from the proximal end of the overtube. The overtube canfurther include at least one sealing band inflation tube for inflatingor deflating the proximal inflatable sealing band.

The overtube can further include at least one fluid/insufflation conduitthat defines a passageway for inflating or suctioning fluid or airwithin the examination compartment within the body cavity at the distalend of the overtube.

The overtube can further include at least one accessory channel thatdefines a passageway for passing accessory tools from the proximal endof the overtube into the examination compartment within the body cavityat the distal end of the overtube.

The overtube can further include at least a suction conduit connected toa suction port situated on the external surface of the overtube betweenthe inflatable positioning ring and the proximal end portion of theovertube. The suction port can be used to remove the secretions thataccumulate proximal to the inflatable positioning ring in the bodycavity.

The overtube can further include at least a flushing port situated onthe external surface of the overtube between the inflatable positioningring and the proximal end portion of the overtube. The flushing port canbe used to inject fluid or gas to flush the body cavity proximal to theinflatable positioning ring in the body cavity.

The overtube can further include fenestration holes connecting theexternal surface of the overtube to the internal surface of theovertube, between the inflatable positioning ring and the proximal endportion of the overtube. The fenestration holes can allow a passivepassage of fluid, secretion, and gas from the lumen of gastrointestinaltract proximal to the inflatable positioning ring to the lumen of theovertube for drainage of the body cavity.

The overtube can further include at least one quick connect fitting. Thequick connect fitting allows a detachable coupling of multiple tubes atthe proximal end portion of the overtube into an umbilical extensiontube. The umbilical extension tube has one quick connect fitting on eachend and serves as an extension tubing to connect the overtube toinflation, irrigation, insufflation or suction devices. The male-femaleinterface of the quick connect fitting allows a detachable connection ofmultiple ports and tubes with one locking action. Examples of the portsand tubes that can be detachably attached through the quick connectfitting can include but are not limited to an inflation tube forpositioning ring, inflation tube for sealing band/s, inflation tube forocclusion balloon, insufflation port for insufflation with gas,irrigation tube for flushing port, suction conduits andfluid/insufflation conduit.

The overtube can further include at least one occlusion balloon quickconnect fitting at the handle at the proximal end portion of theovertube. The male-female interface of the occlusion balloon quickconnect fitting allows a detachable coupling of the proximal end of theocclusion balloon tube to be connected overtube handle. The interface ofthe occlusion balloon quick connect fitting on the overtube handleallows the occlusion balloon to be connected the quick connect fittingthat eventually connects to the umbilical extension tube.

The overtube can further be supplied with an automated control systemfor automated control of inflation, insufflation, irrigating, andsuctioning through the over the tube. The automated control system cancontrol the inflation of the positioning ring, the sealing band/s or theocclusion balloon, insufflation of the compartment, injection orirrigating fluid into the irrigation/drainage port, irrigation conduitof flushing port, and suctioning of the suction conduit/s. The automatedcontrol system can inflate and maintain each individual balloon pressureat an assigned set point, insufflate and maintain the compartmentpressure at an assigned set point, inject fluid into the assigned portand apply suction pressure to an assigned conduit. The activation andset points of the functions are adjusted through knobs or digitaldisplays. The automated control system includes at least one quickconnect fitting. The quick-connect fitting allows a detachable couplingof multiple tubes to the umbilical extension tube. As mentioned above,the umbilical extension tube is connected from the other end to theovertube proximal end portion through another quick connect fitting. Themale-female interface of the quick-connect fitting allows a detachableconnection of multiple ports and tubes with one locking action.

Through the umbilical extension tube, the plurality of the overtube'sports, tubes, and conduit are connected to the corresponding inflation,insufflation, irrigation, and or suctioning tubes on the automatedcontrol system.

The automated control system has a power switch, multiple knobs,buttons, and a digital display for monitoring, adjusting, andcontrolling the various function of the overtube during the procedurebased on the application.

The longitudinal edge portions of the overtube can be supplied with aplurality of spaced magnets covered by a magnet cover comprised of aslit sleeve and the like. The magnets on the longitudinal edge portionsare able to coact upon removal of the magnet cover. The magnet pieces onone edge portion are interspersed with the spaced magnets on the otherlongitudinal edge portion to form the seam.

Alternatively, the longitudinal edge portions of the overtube can besupplied with a linear string of magnets. The magnet strings on eachside of the opposed edge can be covered by a magnet cover comprised of aslit sleeve and the like. The magnets on the longitudinal edge portionsare able to coact upon the removal of the magnet cover. In this form,the magnet beads on one edge portion are not interspersed and coactdirectly with the opposed longitudinal edge portion to form the seam.

Magnets beads can be positioned directly at the edge portion of theovertube, or alternatively, the magnetic beads can be placed in asilicon or plastic tube to form a magnet string, and the tube containingthe magnet string is attached to the longitudinal edge portions of theopposed edges of the longitudinal seam of the overtube. The tubecontaining the magnet beads cab be attached just at the edge, under orover the edge on the opposite side of the seam.

Alternatively, the seam can be created by self-fusing silicon tape,other interlocking mechanisms such as tongue and groove, complementaryedges, hook and loop, zip-lock-type fastener, adhesive tapes, adhesivestraps, self-fusing silicon tapes and straps, and the like or acombination of these mechanisms, particularly the combination ofself-fusing silicon tape and magnet beads.

In use, the endoscope accessory of the claimed invention is a flexible,elongated sheet that envelops the endoscope or echoendoscope shaft whilethe endoscope shaft is still within the body cavity without the need toremove the endoscope or pre-position the overtube over the endoscopeshaft prior to the endoscope insertion within the body cavity. However,as those skilled in the arts can understand, the device could be placedprior to endoscope insertion.

After enveloping or surrounding the endoscope shaft with the sheet, theopposing longitudinal edge portions can be joined to form an overtube bycreating a longitudinal seam along the entire length of the overtube.The opposed longitudinal edge portions of the sheet can be supplied withadhesive, and covered by a release sheet. To form the overtube, therelease sheet is removed, and the opposed longitudinal edge portionscoact using adhesive to form a liquid-tight seam.

After the closure of the overtube seam along the overtube's length, theendoscope shaft is enveloped within the overtube, the handle of theovertube is grasped, and the overtube is pushed into the body cavity ofa patient with the guide of the endoscope shaft to be placed at thedesired location, just proximal to the tip of the endoscope.

The inflatable positioning ring is inflated to secure the position ofthe overtube distal end portion within the body cavity and create a sealbetween the overtube and body cavity.

The inflatable sealing band can be inflated to secure the position ofthe endoscope within the overtube and create a seal around the endoscopeshaft within the overtube. The endoscope can be moved independently ofthe overtube while the sealing band is inflated, keeping the seal. Theendoscope can be replaced when the inflatable sealing band is notinflated, if desired, with another endoscope while the overtube stays inits position within the body cavity.

The occlusion balloon catheter is passed through the catheter passagewayto be placed independently beyond the distal tip of the overtube andendoscope tip. After the inflatable occlusion balloon exits the catheterpassageway at the distal tip of the overtube, it is placed at thedesired location, distal to the distal tip of the endoscope. Then, theinflatable occlusion balloon is inflated. This secures the position ofthe occlusion balloon within the body cavity and also seals the bodycavity from the passage of gas or liquid.

Inflation of the occlusion balloon creates an examination compartment,which is defined by the inflated positioning ring, inflated sealingband, and the inflated occlusion balloon around the tip of the endoscopeat the distal end of the overtube.

The examination compartment can be filled with air, or water, dependingon the applications. In addition, the examination compartment can bethoroughly lavaged using the irrigation tubes connected toirrigation/drainage port or the proximal overtube opening. During theirrigation process, the inflated balloons prevent the escape of air orwater from the examination compartment. During the irrigation process,the endoscope tip can remain at the examination compartment, be pulledback to the proximal end portion of the overtube, or be completelyremoved. In the latter case, the proximal sealing band can be inflatedto seal the overtube completely, or the proximal opening of the overtubecan be closed shut using a proximal overtube cap. Throughout theprocedure, the pressure within the examination compartment can bemaintained and monitored using the fluid/insufflation conduits.

The examination compartment can be made smaller or larger by changingthe position of the occlusion balloon by pushing or pulling thepositioning ring catheter without the need for deflation of thepositioning ring.

The examination compartment can be moved along the body cavity bypushing or pulling the entire overtube without the need for deflation ofthe occlusion balloon, positioning ring, or sealing band.

When the compartment is moved along the body cavity, it maintains itspressure and its content of air or water based on the application. Thisallows the endoscope to examine an extended part of the gastrointestinaltract as the location of the compartment glides over the intestinallumen. At the preference of the user, the movement can be stopped orreversed.

When the compartment is moved along the body cavity while the balloonsare inflated, the movement of the inflated balloons along thegastrointestinal lumen creates a squeegee action and wipes theintestinal wall off of fluid secretion and residuals away from themoving compartment. This allows physical cleaning and wiping of theintestinal lumen before examination by the endoscope. This isparticularly important when the inflated positioning ring wipes theintestinal wall off of fluid and residuals when the overtube is pulledout of the body cavity.

When the compartment is moved along the body cavity while the balloonsare inflated, the squeegee action of the balloons wipes the intestinalwall off of fluid secretion and residuals away from the movingcompartment. During this movement, the flushing port situated on theexternal surface of the overtube between the inflatable positioning ringand the proximal end portion of the overtube is used to inject fluid toflush the body cavity proximal to the inflatable positioning ring. Thisenhances the cleaning squeegee action of the inflated positioning ring.

When the compartment is moved along the body cavity while the balloonsare inflated, the squeegee action of the balloons wipes the intestinalwall off of fluid secretion and residuals away from the movingcompartment. The injected fluid through the flushing port and theluminal fluid and residuals that are propelled during the cleaningsqueegee action of the inflated positioning ring are accumulatedproximal to the inflatable positioning ring over the external surface ofthe overtube. The fenestration holes connecting the external surface ofthe overtube to the internal surface of the overtube between theinflatable positioning ring and the proximal end portion of the overtubeallow a passive passage of fluid, secretion, and gas from the lumen ofthe gastrointestinal tract proximal to the inflated positioning ring tothe lumen of the overtube. The fluid and gas eventually drain from theovertube lumen through the irrigation/drainage port on the overtubehandle. The sealing balloon at the proximal end portion of the overtubeprevents leakage of the fluid from the proximal end of the over thetube.

The examination compartment can be used as a sealed compartment forpossible surgeries or access to spaces outside of the gastrointestinaltract. In that case, after inflating the positioning ring and occlusionballoon, the endoscope can be removed, and other surgical device/sis/are placed within the compartment. The sealing band is inflated orremains deflated based on the user preference. The surgical device cancreate a puncture in the wall of the gastrointestinal tract inside thecompartment to access the space beyond the GI tract lumen. The devicecan perform possible surgical intervention beyond the gastrointestinaltract while the compartment prevents the passage of air and fluid fromother parts of the gastrointestinal tract to the surgical site insidethe compartment. The surgical devices can be used for examination of theperitoneum or to perform intraperitoneal surgeries. After termination ofthe surgical procedure, the surgical device can be removed after sealingband deflation. Then, the opening in the gastrointestinal tract can beclosed by the appropriate device or technique, including using sutures,clips, staples, or the same. Then the endoscope can be reintroduced intothe compartment for further examination.

The occlusion balloon, positioning ring, and sealing band can bedeflated and re-inflated independently of each other or together asdetermined by the user.

After termination of the examination, the positioning ring, sealingband, and occlusion balloon are all deflated, and the overtube isremoved independent of, or together with, the endoscope.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a schematic illustration of the device within the uppergastrointestinal tract.

FIG. 2 is a longitudinal sectional view of the device shown in FIG. 1taken along plane 2-2 when the seam is open.

FIG. 3 is a sectional view of the device shown in FIG. 1 taken alongplane 1-1 when the seam is open.

FIG. 4 is a sectional view of the device shown in FIG. 1 taken alongplane 1-1 when the seam is closed.

FIG. 5 is a longitudinal sectional view of the device shown in FIG. 1taken along plane 2-2 when the seam is closed, and the umbilicalextension tube and occlusion balloon quick connect fitting are connectedto the overtube.

FIG. 6 is a partial schematic illustration of the endoscope accessoryshowing the process of closing the seam by removing the release sheetoff of the adhesive tapes or self-fusing silicon tape and tape straps toattach the opposing longitudinal edge portions and create the seam.

FIG. 7A is a partial schematic illustration of the endoscope accessoryshowing spaced magnets and magnet covers at the longitudinal edgeportions.

FIG. 7B is a partial schematic illustration of the endoscope accessoryshowing spaced magnets and magnet covers at the longitudinal edgeportions after placement of the endoscope shaft and partial closure ofthe longitudinal seam.

FIG. 8A is a partial schematic illustration of the endoscope accessoryshowing magnet strings at the longitudinal edge of the tube and magnetcovers at the longitudinal edge portions.

FIG. 8B is a partial schematic illustration of the endoscope accessoryshowing magnet strings at the longitudinal edge and magnet covers at thelongitudinal edge portions after placement of the endoscope shaft andpartial closure of the longitudinal seam.

FIG. 9A is a partial schematic illustration of the endoscope accessoryshowing magnet strings under the longitudinal edge of the tube andmagnet covers at the longitudinal edge portions.

FIG. 9B is a partial schematic illustration of the endoscope accessoryshowing magnet strings under the longitudinal edge of the tube, and onemagnet cover is being removed by pulling back from one side at thelongitudinal edge portions.

FIG. 9C is a partial schematic illustration of the endoscope accessoryshowing magnet strings under the longitudinal edge of the tube, and bothmagnet covers are being removed by pulling back from both sides at thelongitudinal edge portions.

FIG. 9D is a partial schematic illustration of the endoscope accessoryshowing magnet strings under the longitudinal edge and magnet covers atthe longitudinal edge portions after placement of the endoscope shaftand partial closure of the longitudinal seam.

FIG. 10A is a partial schematic illustration of the endoscope accessoryshowing magnet strings under the longitudinal edge of the tube and onemagnet cover at the longitudinal edge portions, and adhesive tape beltsfor closing the seam after removing the release sheets to attach overthe opposing edge portions.

FIG. 10B is a partial schematic illustration of the endoscope accessoryshowing magnet strings under the longitudinal edge and one magnet coverat the longitudinal edge portions after placement of the endoscope shaftand partial closure of the longitudinal seam by magnets showing theadhesive tape belts for closing the seam after removing the releasesheets to attach over the opposing edge portions after closure of seam.

FIG. 11A is a partial schematic illustration of the endoscope accessoryshowing a magnet string flap under one longitudinal edge of the tube andmagnet string under the other longitudinal edge of the tube and magnetcovers at the longitudinal edge portions holding up the magnet flap onone side and cover the magnet string on the other side.

FIG. 11B is a partial schematic illustration of the endoscope accessoryshowing one magnet string flap at the longitudinal edge of the tube onone side while its magnet cover is being partially removed bylongitudinally retracting the magnet cover, releasing the magnet stringflap, allowing the magnet string flap to swing toward the opposing edgeportion. The other opposing edge is supplied with magnet string underthe longitudinal edge of the tube and a magnet cover at the longitudinaledge portions covering the magnet string to prevent attraction from theopposing edge magnets.

FIG. 12A is a partial schematic illustration of the endoscope accessoryshowing magnet string flaps under the longitudinal edge of the tube andmagnet covers at the longitudinal edge portions holding up the magnetflaps.

FIG. 12B is a partial schematic illustration of the endoscope accessoryshowing one magnet string flap at the longitudinal edge of the tube onone side while its magnet cover is being partially removed bylongitudinally retracting the magnet cover, releasing the magnet stringflap, allowing the magnet string flap to swing toward the opposing edgeportion. The other opposing edge is supplied with another magnet stringflap under the longitudinal edge of the tube, and its magnet cover atthe longitudinal edge portions holding up the magnet flap under thelongitudinal edge of the tube to prevent attraction from the opposingedge magnets.

FIG. 12C is a partial schematic illustration of the endoscope accessoryshowing magnet string flaps at the longitudinal edge of the tube on bothsides while the magnet covers are being partially removed bylongitudinally retracting the magnet covers, releasing the magnet stringflaps, allowing the magnet string flaps to swing toward the opposingedge portions. The released magnet string flaps are allowed to attractthe opposing edge magnet string flap.

FIG. 12D is a partial schematic illustration of the endoscope accessoryshowing magnet string flaps at the longitudinal edge of the tube on bothsides while the magnet covers are being partially removed bylongitudinally retracting the magnet covers, releasing the magnet stringflaps, allowing the magnet string flaps to swing toward the opposingedge portions after placement of the endoscope shaft. The releasedmagnet string flaps are allowed to attract the opposing edge magnetstring flap, that results in partial closure of the longitudinal seam.

FIG. 13A is a partial schematic illustration of the endoscope accessoryshowing an open-ended zipper at the longitudinal edge of the tube in afully opened status.

FIG. 13B is a partial schematic illustration of the endoscope accessoryshowing an open-ended zipper at the longitudinal edge of the tube afterthe zipper insert pin from one edge is placed in the zipper retainingbox from the opposing edge and the slider is moved to engage the zipperteeth that results in partial closure of the longitudinal seam.

FIG. 14A is a partial schematic illustration of the endoscope accessoryshowing an open-ended toothless zipper at the longitudinal edge of thetube in a fully opened status.

FIG. 14B is a partial schematic illustration of the endoscope accessoryshowing an open-ended toothless zipper at the longitudinal edge of thetube after the zipper insert pin from one edge is placed in the zipperretaining box from the opposing edge and the slider is moved to engagethe zipper locking edges that results in partial closure of thelongitudinal seam.

FIG. 15 is a schematic illustration of the umbilical extension tube andthe automated control system.

FIG. 16A is a schematic illustration of the endoscope accessory creatingan examination compartment within the lower gastrointestinal tract andaccess beyond the GI tract and in FIG. 16A endoscope is the center ofthe compartment.

FIG. 16B shows the endoscope in the center of the compartment at a bendin the colon.

FIG. 16C shows the endoscope facing the GI tract wall.

FIG. 16D shows the endoscope is creating a passage in the GI tract wall.

FIG. 16E shows the endoscope passing beyond the GI tract wall into theperitoneal cavity.

FIG. 17A is a perspective view of an alternate embodiment of the presentinvention depicting endoscope accessory with the endoscope in theovertube, and the irrigation/drainage port is uncapped and is connectedto an irrigation/drainage tube connector.

FIG. 17B is a perspective view of an alternate embodiment of the presentinvention depicting endoscope accessory with no endoscope in theovertube and the irrigation/drainage port is capped, and the proximalend of the overtube is closed using a cap plug attached to a string.

FIG. 17C is a perspective view of an alternate embodiment of the presentinvention depicting an endoscope accessory with no endoscope in theovertube and the irrigation/drainage port is capped, and the proximalend of the overtube is connected to an irrigation/drainage tubeconnector.

DETAILED DESCRIPTION OF THE INVENTION

Before explaining some aspects of the embodiment of the presentinvention in detail, it is to be understood that the present inventionis not limited in its application to the details of arrangements of thecomponents set forth in the following description. As can be appreciatedby those skilled in the arts, the present invention is capable of otherembodiments and of being practiced and carried out in various ways.Also, it is to be understood that the phraseology and terminologyemployed herein are for the purpose of description and should not beregarded as limiting. It is also to be understood that where ranges areprovided for various aspects of the invention, and for example, they areapproximate ranges and are not to be limiting except where notedotherwise.

Unless defined otherwise, all technical and scientific terms used hereinhave the same meaning as commonly understood by one of ordinary skill inthe art to which this invention belongs. Moreover, the singular forms“a”, “an”, and “the” include plural referents unless the context clearlydictates otherwise.

Use of the word endoscope includes any device that would benefit fromthe use of an endoscopy accessory made according to the principles ofthe invention for examination, diagnosis, or treatment.

Use of the word endoscope or echoendoscope is meant to include bothunless context dictates otherwise.

Use of word gastrointestinal tract is a generic form of a body cavitythat can be visualized by endoscopic exam. Those skilled in the art knowthat the proposed device can be used in any other body cavity that canbe examined by endoscopes, including but not limited to all othervisceral organs and non-visceral body organs.

Use of the word water is also meant to include any useful fluid,including but not limited to medications or gels.

Additionally, while the word examination is used, it is meant to includealso diagnosis, treatment, or therapy, as may be the case.

According to certain embodiments of the present invention, an endoscopeaccessory 10 can include:

A-Overtube: As it is depicted in FIG. 1 , an overtube 11, as shown inFIG. 1 , which can define an essentially cylindrical central throughpassageway for receiving there within an endoscope or echoendoscopeshaft 91 and then is inserted inside a body cavity such as thegastrointestinal tract.

Overtube 11 has an external surface 12 and an internal surface (notshown in FIG. 1 ), a proximal end portion 14, a midportion 15, a distalend portion 16, a proximal opening 17, and a distal opening 18. Overtube11 can include at least one handle 19 at its proximal end portion 14.Handle 19 on the external surface 12 at the proximal end portion 14 ofthe overtube 11 is for grasping and manipulation of the overtube 11within the body cavity. Handle 19 is also a hub where a plurality ofexternal inflation tubes, quick connect fitting, occlusion balloon quickconnect fitting (not shown in FIG. 1 ), and irrigation/drainage port canconnect to overtube 11 and can be used for connection of the overtube toinflation device, suction device, irrigation tubes or passage oftherapeutic tools through overtube 11.

The length of overtube 11 can be long enough so that when the distal endportion 16 of the overtube 11 is secured inside the body cavity, theovertube proximal end portion 14 stays out of the body cavity and allowsgrasping of the handle 19 and manipulation of overtube 11 for properpositioning of the overtube distal end portion 16 within the body cavityby the operator. The diameter of overtube 11 can be wide enough tofreely receive a regular endoscope or echoendoscope shaft 91therewithin. Within the body cavity, the endoscope tip 92 extends beyondovertube 11 distal end portion 16, as shown in FIG. 1 , for detailedexamination of the body cavity. Overtube 11 can include a longitudinalseam 51 along its entire length that allows opening of overtube 11 alongits entire length for placing the endoscope shaft 91 within overtube 11without the need for removing endoscope shaft 91 from the body cavity.The irrigation/drainage port 111 projects over the handle 19 and iscapped by the irrigation/drainage port cap 112.

The overtube 11 can further include at least a suction conduit port 71situated on the external surface 12 of the overtube 11 between theinflatable positioning ring 22 and the proximal end portion 14 of theovertube 11. The suction conduit port 71 can be used to drain air orwater from the body cavity accumulated proximal to positioning ring 22.

The overtube 11 can further include at least one flushing port 75situated on the external surface 12 of the overtube 11 between theinflatable positioning ring 22 and the proximal end portion 14 of theovertube 11. The flushing conduit (not shown) terminates distally at aflushing port 75 (shown in FIGS. 1 and 16 ) and proximally extends toquick connect fitting 140 on the handle 19 at proximal end portion 14 ofovertube 11 and can be connected to an automated control system 180. Theflushing port 75 can be used to inject fluid or gas to flush the bodycavity proximal to the inflatable positioning ring 22 in the bodycavity.

The overtube 11 can further include at least a fenestration hole 77situated on the external surface 12 of the overtube 11 between theinflatable positioning ring 22 and the proximal end portion 14 of theovertube 11. The fenestration hole 77 connects the external surface 12of the overtube 11 to the internal surface 13 of the overtube 11,between the inflatable positioning ring 22 and the proximal end portion14 of the overtube 11. The fenestration hole/s can allow a passivepassage of fluid, secretion and gas from the lumen of thegastrointestinal tract proximal to the inflatable positioning ring 22 tothe lumen of the overtube for drainage of the body cavity.

As it is depicted in FIG. 2 , overtube 11 of the endoscope accessory 10is composed of a flexible elongated sheet 101, sized to removablyenvelop the flexible endoscope or echoendoscope shaft, having face 102and face 103, a proximal end portion 104, a midportion 105, a distal endportion 106, and opposed longitudinal edge portions 107 and 108 (neitherare shown in FIG. 2 ) that can coact reversibly to form a flexibleovertube 11 (FIG. 1 ). Face 103 forms inner surface 13 (shown in FIG. 4) of overtube 11 which defines a central through passageway forreceiving therewithin the endoscope or echoendoscope shaft 91 which canbe inserted inside a body cavity such as gastrointestinal tract (FIG. 1).

The sheet 101 is further provided with a strip 109 on face 102 of thesheet 101, which can extend across the entire width of the sheet 101 atthe proximal end portion 104 of the sheet 101. An inflatable pocket 21on face 102 of sheet 101 extends across the entire width of sheet 101 atthe distal end portion 106 of the sheet 101, forming an inflatablepositioning ring 22 (FIG. 1 ) on external surface 12 of overtube 11.

As it is depicted in FIG. 2 , at least one inflatable band 31 can belocated on face 103 of sheet 101 at a distal end portion 106 of sheet101. At least one inflatable band 33 can be located on face 103 of sheet101 at proximal end portion 104 of sheet 101. More inflatable bands canbe located on face 103 of sheet 101 at mid-portion 105 of sheet 101 (notshown). When opposed longitudinal edge portions 107 and 108 (neither areshown in FIG. 2 ) coact to form a flexible overtube 11, the inflatableband 31 forms an inflatable sealing band 32 at the distal end portion16, internal surface 13 of flexible overtube 11 (FIG. 5 ) and theinflatable band 33 forms inflatable sealing band 34 at the proximal endportion 14, on the internal surface 13 of flexible overtube 11 (FIGS. 4and 5 ).

Inflatable sealing bands 32 or 34 can be inflated independently usingsealing band inflation tubes (not shown) that are carried by overtube 11and terminate in quick connect fitting 140 at the handle 19 of theovertube 11.

An alternative embodiment in sheet 101 can be an elongated elastomericbead (not shown) on face 103 of sheet 101 that can be provided in lieuof inflatable pocket 31, extending across the entire width of the sheetat proximal end portion 104 of sheet 101. Elastomeric bead 36 can forman elastomeric sealing bead on internal surface 13 of overtube 11 (notshown) when opposed longitudinal edge portions 107 and 108 coact to formovertube 11. Those skilled in arts can quickly understand elastomericbead 36 can be multiple, replace one or more sealing bands and belocated at any point along the length of overtube 11.

On face 102, there can be a strip 109 disposed at proximal end portion104 of sheet 101. The strip 109 is supplied with a quick connect fitting140, occlusion balloon quick connect fitting 190 and catheter portprojection 64 that all projects over strip 109. When opposedlongitudinal edge portions 107 and 108 (neither are shown in FIG. 2 )coact to form a flexible overtube 11, the strip 109 forms handle 19 onthe external surface 12 of flexible overtube 11 (FIGS. 1 and 4 and 5 ).

As it is depicted in FIG. 2 , the strip 109 of the overtube 101 of theendoscope accessory 10 is supplied with a quick connect fitting 140. Thequick connect fitting 140 allows a detachable coupling of multiple tubesat the proximal end portion 14 of the overtube 11 into an umbilicalextension tube (not shown in FIG. 2 ). The umbilical extension tube hasone quick connect fitting on each end and serves as an extension tubingto connect the overtube 11 to inflation, irrigation, insufflation orsuction devices. The male-female interface (The ring connection 141 overthe handle is only shown in this figure) of the quick connect fittingallows a detachable connection of multiple ports and tubes with onelocking action.

As it is depicted in FIG. 2 , a catheter passageway (not shown) canextend outward as a catheter port projection 64 over the strip 109 atthe proximal end portion 104 of sheet 101. Catheter passagewayterminates in a catheter entrance port 65 at the tip of catheter portprojection 64. Catheter passageway defines a through passageway forreceiving therewithin a catheter or other endoscopic accessories. Afteropposed longitudinal edge portions 107 and 108 coact to form flexibleovertube 11, catheter passageway can be used for passing a catheter oran endoscope accessory device by overtube 11. A catheter or endoscopicaccessory device can be inserted into catheter entrance port 65 oncatheter port projection 64 and passed through catheter passageway andexit from the catheter exit port 61 (shown in FIG. 11A) inside the bodycavity, such as the gastrointestinal tract.

As it is depicted in FIG. 3 , the strip 109 of the sheet 101 of theendoscope accessory 10 is supplied with a quick connect fitting 140.This figure also shows an inflatable band 33 attached to the internalsurface 103, at the proximal end portion 104 of the sheet 101. The edgesof the inflatable band 33 end at the opposed longitudinal edge portions107 or 108 of the sheet 101.

As it is depicted in FIG. 4 , when opposed longitudinal edge portions107 and 108 coact to form a seam 51, the flexible overtube 11 is formed.Then, the strip 109 forms handle 19 on the external surface 12 offlexible overtube 11. After closure of seam 51, the inflated band 33 canbe eccentric relative to longitudinal axis of overtube 11 in a way thatinflatable sealing band 34 and overtube internal surface 13 createinternal tangent circles. The tangent point of these two circles can beat longitudinal seam 51. This allows a better sealing created byinflatable sealing band 34 over endoscope shaft 91. The ports and tubes142-146 can be detachably attached through the quick connect fitting 140used for purpose of inflation, insufflation, irrigation, suctioning.

As it is depicted in FIG. 5 , the handle 19 of the overtube 11 of theendoscope accessory 10 is supplied with a quick connect fitting 140. Thequick connect fitting 140 allows a detachable coupling of multiple tubesat the proximal end portion 14 of the overtube 11 into an umbilicalextension tube 150. The umbilical extension tube 150 has one quickconnect fitting on each end and serves as an extension tubing to connectthe endoscope accessory 10 to an automated control system (not shown inFIG. 5 ). The ring connection 141 over the handle 19 of the quickconnect fitting 140 allows a detachable connection to the umbilicalextension tube 150 to a ring 151 in a male-female fashion.

In this figure, also it is shown, the occlusion balloon catheter. Theocclusion balloon inflation tube 85 joins occlusion catheter suctiontube 86 carried by occlusion balloon catheter 80. The occlusion ballooninflation tube 85 terminates at an occlusion balloon quick connectfitting 87. The occlusion catheter suction tube 86 terminates at anocclusion catheter suction connection piece 88. The occlusion balloonquick connect fitting 87 connects to the interface of the quick fitting190 on the handle 19 of the overtube 11. The occlusion catheter suctiontube 86 terminates at an occlusion catheter suction tip 89 (shown inFIGS. 1 and 16A-16E) that can be used to drain air or water accumulatedwithin the body cavity distal to inflatable occlusion balloon 84 (shownin FIGS. 1 and 16A-16E).

As it is depicted in FIG. 6 , sheet 101 can wrap around or envelopendoscope shaft 91 while opposed longitudinal edge portions 107 and 108are still apart. The opposed longitudinal edge portions 107 and 108 canbe supplied with an adhesive 52 covered by a release sheet 53. Afterremoval of release sheet 53 from adhesive 52, at least one of theopposed longitudinal edge portions 107 and 108, opposed longitudinaledge portions 107 and 108 can be overlapped to form longitudinal seam 51along the entire length of overtube 11 (shown in FIG. 1 ) to form anessentially cylindrical and hollow member. The opposed longitudinal edgeportions 107 and 108 can be further supported with adhesive straps 60that is permanently adhered on the outer surface 102 or inner surface103 of the sheet 101 on one side of the tube edge and crosses over theseam 51 and adheres to the outer surface 12 of the overtube 11 tofurther strengthen the seam 51.

An alternative embodiment of sheet 101 is depicted in FIGS. 7A and 7B.As it is shown in FIG. 7A, the closure can include a plurality of spacedmagnets 54 that is provided in lieu of adhesive 52 and release sheet 53,carried by each longitudinal edge portions 107 and 108 along the entirelength of sheet 101 for coacting with the opposed edge portion. Spacedmagnets 54 on longitudinal edge portion 107 are interspersed with spacedmagnets on the longitudinal edge portion 108 (FIG. 8B). The inflatablepocket 21 and the inflatable band 31 are offset from magnets 54. Toavoid activation of the magnets 54 before placing endoscope shaft 91within sheet 101, longitudinal edge portions 107 and 108 can be suppliedwith at least one longitudinal slit sleeve magnet cover 55. Magnets 54can coact with the opposed longitudinal edge portion magnets 54 whenmagnet covers 55 are removed by longitudinal retraction of the magnetcover 55 from longitudinal edge portions 107 and 108.

As it is depicted in FIG. 7B, when magnet covers 55 are removedpartially by longitudinal retraction of the magnet cover 55 proximally,distal end portion 106 of sheet 101 magnets 54 at the opposedlongitudinal edge portions 107 and 108 coact. The coacting magnets 54are in the form of spaced magnet pieces that are positioned next to eachother in a row. The magnet pieces 54 are spaced apart to create a zipperclosure that assembles longitudinal seam 51 starting from distal endportion 16 of overtube 11. Repeating this sequence closes longitudinalseam 51 along entire length of flexible overtube 11 and overtube 11forms around endoscope shaft 91.

An alternative embodiment of sheet 101 is depicted in FIGS. 8A and 8B.As it is shown in FIG. 8A, the closure can include a plurality ofnon-spaced magnets 56 that is provided in lieu of adhesive 52 andrelease sheet 53 or spaced magnets 54, carried by each longitudinal edgeportions 107 and 108 along entire length of sheet 101 for coacting withthe opposed edge portion. The plurality of non-spaced magnets 56 onlongitudinal edge portions 107 and 108 are attached individually at theedge portions 107 and 108. The inflatable pocket 21 and the inflatableband 31 are offset from non-spaced magnets 56. To avoid activation ofthe non-spaced magnets 56 before placing endoscope shaft 91 within sheet101, longitudinal edge portions 107 and 108 can be supplied with atleast one longitudinal slit sleeve magnet cover 55. Non-spaced magnets56 can coact with the opposed longitudinal edge portion non-spacedmagnets 56 when magnet covers 55 are removed by longitudinal retractionof the magnet cover 55 from longitudinal edge portions 107 and 108.

As it is depicted in FIG. 8B, when magnet covers 55 are removedpartially by longitudinal retraction of the magnet cover 55 proximally,distal end portion 106 of sheet 101 non-spaced magnets 56 at the opposedlongitudinal edge portions 107 and 108 coact. The coacting non-spacedmagnets 56 assemble longitudinal seam 51 starting from distal endportion 16 of overtube 11. Repeating this sequence closes longitudinalseam 51 along entire length of flexible overtube 11 and overtube 11forms around endoscope shaft 91.

An alternative embodiment of sheet 101 is depicted in FIGS. 9A, 9B, 9Cand 9D. As it is shown in FIG. 9A, the closure can include a pluralityof magnets in the form of a magnet strings 57 that are provided in lieuof adhesive 52 and release sheet 53 or spaced magnets 54, or non-spacedmagnets 56 carried by each longitudinal edge portions 107 and 108 alongentire length of sheet 101 for coacting with the opposed edge portion.The magnet strings 57 are composed of plurality of magnet bids that arehold together in a thin tube like structure 58. Each tube like structure58 containing magnet strings 57 is attached at the edge, under the edgeor above the edge at the longitudinal edge portions 107 and 108. Theinflatable pocket 21 and the inflatable band 31 are offset from magnetstrings 57. To avoid activation of the magnet string 57 before placingendoscope shaft 91 within sheet 101, longitudinal edge portions 107 and108 can be supplied with at least one longitudinal slit sleeve magnetcover 55. Magnet string 57 can coact with the opposed longitudinal edgeportion magnet string 57 when magnet covers 55 are removed bylongitudinal retraction of the magnet cover 55 from longitudinal edgeportions 107 and 108.

As it is depicted in FIG. 9B, when magnet covers 55 are removedpartially by longitudinal retraction of the magnet cover 55 proximally,distal end portion 106 of sheet 101 magnet string 57 at the opposedlongitudinal edge portions 107 followed by the same on the opposedlongitudinal edge portions 108 (FIG. 9C), the magnet strings 57 fromboth side coact. The coacting magnet string 57 assembles longitudinalseam 51 starting from distal end portion 16 of overtube 11 (FIG. 9D).Repeating this sequence closes longitudinal seam 51 along entire lengthof flexible overtube 11, and overtube 11 forms around endoscope shaft91.

An alternative embodiment of sheet 101 is depicted in FIGS. 10A and 10B.As it is shown in FIG. 10A, the closure can include a plurality ofmagnets in the form of a spaced magnets 54, magnets 55, or magnetstrings 57 that are provided in lieu of adhesive 52 and release sheet53. The opposed longitudinal edge portions 107 and 108 can be furthersupported with adhesive straps 60 that are permanently adhered on theouter surface 102 or inner surface 103 of the sheet 101 on one side ofthe tube edge and crosses over the seam 51 and adheres to the outersurface 12 of the overtube 11 to further strengthen the seam 51. Toavoid activation of the spaced magnets 54, magnets 55, or magnet strings57 before placing endoscope shaft 91 within sheet 101, longitudinal edgeportions 107 and 108 can be supplied with at least one longitudinal slitsleeve magnet cover 55 (in this figure only one on the edge 108). Magnet54, magnets 55, or magnet strings 57 can coact with the opposedlongitudinal edge portion magnet string 57 when magnet cover 55 isremoved by longitudinal retraction of the magnet cover 55 fromlongitudinal edge portion 108.

As it is depicted in FIG. 10B, when magnet cover 55 is removed partiallyby longitudinal retraction of the magnet cover 55 proximally, distal endportion 106 of sheet 101 magnet 54, magnets 55 or magnet strings 57 atthe opposed longitudinal edge portions 107 and 108 coact. The coactingmagnets assembles longitudinal seam 51 starting from distal end portion16 of overtube 11. Repeating this sequence closes longitudinal seam 51along entire length of flexible overtube 11 and overtube 11 forms aroundendoscope shaft 91. The opposed longitudinal edge portions 107 and 108can be further supported with adhesive straps 60 that is permanentlyadhered on the outer surface 102 or inner surface 103 of the sheet 101on one side of the tube edge and crosses over the seam 51 and adheres tothe outer surface 12 of the overtube 11 to further strengthen the seam51.

An alternative embodiment of sheet 101 is depicted in FIGS. 11A and 11B.As it is shown in FIG. 11A, the closure can include a plurality ofmagnets in a form of a magnet string flap 59 that are provided in lieuof adhesive 52 and release sheet 53 or spaced magnets 54, non-spacedmagnets 56, or magnet strings 57 carried by at least one longitudinaledge portions 107 and 108 along entire length of sheet 101 for coactingwith the opposed edge portion. The magnet string flap 59 is composed ofplurality of magnet bids that are held together as a magnet string in athin tube-like structure 58 that is attached to the edge portion of thetube only along one longitudinal line and can swing on the longitudinalaxis while attached to the edge portion 107 and 108. The magnet stringflap is kept under the edge or above the edge at the longitudinal edgeportions 107 and 108 using the magnet cover 55. The inflatable pocket 21and the inflatable band 31 are offset from magnet string flap 59. Inthis particular configuration, the other edge portion 108 of the sheet101 is supplied with a magnet string 57. To compensate for the heightdifference at least one edge 107 or 108 can have thicker end portion (inthis figure, edge 107). To avoid activation of the magnet string flap 59or magnet string 57 before placing endoscope shaft 91 within sheet 101,longitudinal edge portions 107 and 108 can be supplied with at least onelongitudinal slit sleeve magnet cover 55. Magnet string flap 59 cancoact with the opposed longitudinal edge portion magnet string 57 whenmagnet covers 55 are removed by longitudinal retraction of the magnetcover 55 from longitudinal edge portions 107 and 108.

As it is depicted in FIG. 11B, when magnet covers 55 are removedpartially by longitudinal retraction of the magnet cover 55 proximally,distal end portion 106 of sheet 101 magnet string flap 59 is released.This allows the distal end portion of the magnet string flap 59 on theedge portion 107 to swing toward the opposed edge portion 108 magnetstring 57. The coacting magnet string 57 assembles longitudinal seam 51starting from distal end portion 16 of overtube 11. Repeating thissequence closes longitudinal seam 51 along entire length of flexibleovertube 11 and overtube 11 forms around endoscope shaft 91.

An alternative embodiment of sheet 101 is depicted in FIGS. 12A, 12B,12C and 12D. As it is shown in FIG. 12A, the closure can include aplurality of magnets in a form of a magnet string flaps 59 that areprovided in lieu of adhesive 52 and release sheet 53 or spaced magnets54, non-spaced magnets 56, or magnet strings 57 carried by longitudinaledge portions 107 and 108 along entire length of sheet 101 for coactingwith the opposed edge portion. The magnet string flap 59 is composed ofplurality of magnet bids that are held together as a magnet string in athin tube like structure 58 that is attached to the edge portion of thetube only along one longitudinal line and can swing on the longitudinalaxis while attached to the edge portion 107 and 108. The magnet stringflap is kept under the edge or above the edge at the longitudinal edgeportions 107 and 108 using the magnet cover 55. The inflatable pocket 21and the inflatable band 31 are offset from magnet string flap 59. Toavoid activation of the magnet string flap 59 before placing endoscopeshaft 91 within sheet 101, longitudinal edge portions 107 and 108 can besupplied with longitudinal slit sleeve magnet cover 55. Magnet stringflap 59 can coact with the opposed longitudinal edge portion magnetstring flap 59 when magnet covers 55 are removed by longitudinalretraction of the magnet cover 55 from longitudinal edge portions 107and 108.

As it is depicted in FIG. 12B, when magnet covers 55 are removedpartially by longitudinal retraction of the magnet cover 55 proximally,distal end portion 106 of sheet 101 magnet string flap 59 is released.This allows the distal end portion of the magnet string flap 59 on theedge portion swings toward the opposed edge portion, followed by thesame on the opposed longitudinal edge portions (FIG. 12C). The coactingmagnet string flaps 59 assembles longitudinal seam 51 starting fromdistal end portion 16 of overtube 11 (FIG. 12D). Repeating this sequencecloses longitudinal seam 51 along the entire length of flexible overtube11 and overtube 11 forms around endoscope shaft 91.

An alternative embodiment of sheet 101 is depicted in FIGS. 13A and 13B.As it is shown in FIGS. 13A and 13B, the closure can include a zipper190 that is provided in lieu of adhesive 52 and release sheet 53 orspaced magnets 54, non-spaced magnets 56, magnet strings 57 or magnetstring flap 59 carried by longitudinal edge portions 107 and 108 alongthe entire length of sheet 101 for approximation of the opposed edgeportions. The zipper 190 is an open ended zipper that is composed of twozipper tapes, 191 and 192 (neither are shown), that are attached underor over the edge portions 107 and 108 of the tube, respectively. Thezipper tape 191 has an insert pin 193 at its distal end, and the zippertape 192 has a box pin 194 that is permanently placed in a retaining box195. The insert pin 193 can be removably placed in the retaining box 195and then allow the slider 196 to be moved and engage the zipper teeth197 on each side and close the zipper. The inflatable pocket 21 and theinflatable band 31 are offset from zipper 190.

As it is depicted in FIG. 13B, the engagement of the zipper tape 191with zipper tape 192 from its distal end toward its proximal endassembles longitudinal seam 51 starting from distal end portion 16 ofovertube 11. Continuing to pull the slider 196 proximally closeslongitudinal seam 51 along the entire length of flexible overtube 11 andovertube 11 forms around endoscope shaft 91.

An alternative embodiment of sheet 101 is depicted in FIGS. 14A and 14B.As it is shown in FIGS. 14A and 14B, the closure can include a toothlesszipper 200 that is provided in lieu of adhesive 52 and release sheet 53or spaced magnets 54, non-spaced magnets 56, magnet strings 57, magnetstring flap 59 or zipper 190, carried by longitudinal edge portions 107and 108 along the entire length of sheet 101 for approximation of theopposed edge portions. The zipper 200 is an open-ended toothless zipperthat is composed of two zipper tapes, 201 and 202, that are attachedunder or over the edge portions 107 and 108 of the tube, respectively.The zipper tape 200 has an insert pin 203 at its distal end and thezipper tape 202 has a box pin 204 that is permanently placed in aretaining box 205. The insert pin 203 can be removably placed in theretaining box 205 and allow the slider 206 to be moved and engage thezipper locking edges 207 and 208 on each side and close the zipper. Theinflatable pocket 21 and the inflatable band 31 are offset from zipper190.

As it is depicted in FIG. 14B, the engagement of the zipper tape 201with zipper tape 202 from its distal end toward its proximal endassembles longitudinal seam 51 starting from the distal end portion 16of overtube 11. Continuing to pull the slider 206 proximally closeslongitudinal seam 51 along the entire length of flexible overtube 11 andovertube 11 forms around endoscope shaft 91.

A further alternative embodiment of sheet 101 could be other closuremechanism for the opposing longitudinal edge portions 107 and 108. Thisincludes cooperating coupling structures (not shown) that can provide aninterlocking closure mechanism in a tongue and groove, complementarybeveled or stepped edges, silicon longitudinal flap, or a combination ofmechanisms such as magnets beads, magnet strings, adhesive tape,adhesive tape straps, self-fusing silicon tape or self-fusing silicontape straps (neither is shown).

B-Catheter and Occlusion Balloon:

As it is depicted in FIG. 1 , the occlusion balloon catheter 80 isconnected to an occlusion balloon 84 at distal end portion. Occlusionballoon 84 can be mounted on occlusion balloon catheter 80 in preferablyan asymmetrical manner but can also be mounted in an essentiallysymmetrical manner. In the asymmetrical form (not shown), the occlusionballoon catheter 80 is situated eccentrically in relation to theocclusion balloon 84. Occlusion balloon 84 can be inflated by anocclusion balloon inflation tube 85 that can be carried by an occlusionballoon catheter 80. An occlusion catheter suction tube 86 can also becarried by an occlusion balloon catheter 80. At midportion of theocclusion balloon catheter 80, occlusion balloon inflation tube 85, andocclusion catheter suction tube 86 can be disposed of side-by-side. Atthe proximal end portion of the occlusion balloon catheter 80, occlusionballoon inflation tube 85 and occlusion catheter suction tube 86 can beseparated and terminated at an quick connect fitting 87 and theocclusion catheter suction connection piece 88, respectively. At thedistal end portion of occlusion balloon catheter 80, occlusion ballooninflation tube 85 communicates with occlusion balloon 84 and occlusioncatheter suction tube 86 passes through occlusion balloon 84 toterminate at an occlusion catheter suction tip 89 that can be used todrain air or water accumulated within the body cavity distal toinflatable occlusion balloon 84.

Distal end portion of the occlusion balloon catheter 80 can beindependently positioned distal to distal end portion 16 of overtube 11within the body cavity. Proximal end portion of occlusion ballooncatheter 81 can extend out of catheter passageway entrance port 65 on acatheter passageway port projection 64 of overtube 11.

C-Automated Control System and Umbilical Extension Tube:

As it is dep15, the endoscope accessory 10 is supplied with an umbilicalextension tube 150 and an automated control system 180.

The endoscope accessory 10 can further include at least one quickconnect fitting (shown in previous figures). The quick connect fittingallows a detachable coupling of multiple tubes at the proximal endportion of the overtube into an umbilical extension tube 150. Theumbilical extension tube 150 has one quick connect fitting 151 and 161on each end and serves as an extension tubing to connect the overtube 11to an automated control system 180 for inflation, irrigation,insufflation or suctioning. The male-female interface 141 to 151 and 161to 171 of the quick connect fitting on each end of the umbilicalextension tube 150 allows a detachable connection of multiple ports andtubes with one locking action. Examples of the ports and tubes that canbe detachably attached through the quick connect fitting can include butare not limited to an inflation tube for positioning ring, inflationtube for sealing band/s, inflation tube for occlusion balloon,insufflation port for insufflation with gas, irrigation tube forflushing port, suction conduits and fluid/insufflation conduit.

The automated control system 180 has a power switch 181, multiple knobs183, 185, 187, buttons 182, 184, and 186, and digital display 188 formonitoring, adjusting, and controlling the various function of theovertube during the procedure based on the application.

D-Irrigation Tubes:

As it is depicted in FIG. 17A, handle 19 can define irrigation/drainageport 111 that is capped with a removable irrigation/drainage port cap112 (FIG. 1 ). Irrigation/drainage port cap 112 can be removed whendesired, and an irrigation tube system 110 can be connected throughirrigation tube connector 113 to irrigation/drainage port 111 while thescope is within the over tube (FIG. 17A) or when the endoscope shaft 91is removed from the overtube, and an end cap 115 close the proximal end17 of the overtube (FIG. 17B). A clean water irrigation tube 121 and awastewater irrigation tube 131 can both terminates at the irrigationtube connector 113 side by side.

Clean water can be infused within the examination compartment 95 throughthe lumen of overtube 11 using clean water irrigation tube 121. The flowof water within clean water irrigation tube 121 can be controlled usinga slit valve 122. Clean water irrigation tube 121 can be connected to acontainer (not shown) of fresh water during irrigation of examinationcompartment 95 using a connection piece 123.

Wastewater can be drained from the examination compartment 95 throughthe lumen of overtube 11 using wastewater irrigation tube 131. The flowof water within wastewater irrigation tube 131 can be controlled using aslit valve 132. Wastewater irrigation tube 131 can be connected to acontainer (not shown) of wastewater during the irrigation of examinationcompartment 95 using a connection piece 133.

Alternatively, as depicted in FIG. 17C, irrigation system 110 can beconnected through irrigation tube connector 113 to proximal opening 17of overtube 11 when endoscope shaft 91 is not in overtube 11. In thisconfiguration, irrigation/drainage port 111 can be capped byirrigation/drainage port cap 112.

E-Operation.

Endoscope tip 92 can be inserted into a body cavity, such as thegastrointestinal tract, to reach to the desired location within the bodycavity. At this time, endoscope accessory sheet 101 is wrapped aroundendoscope shaft 91 and opposed longitudinal edge portions 107 and 108coact to form flexible overtube 11 enveloping shaft of endoscope 91 overthe portion of shaft 91 that is still outside of the subject's bodycavity.

As shown in FIG. 6 , adhesive 52 and release sheet 53, and adhesivestraps 60 are carried by longitudinal edge portions 107 and 108 alongentire length of sheet 101 for approximation of the opposed edgeportions. Alternatively, the opposed edge portions can be approximatedto assemble the seam 51 using spaced magnets 54 (FIG. 7A, 7B),non-spaced magnets 56 (FIG. 8A, 8B), magnet strings 57 (FIG. 9A, 9B, 9C,9D), magnet string flap 59 (FIGS. 12A, 12B, 12C, 12D), zipper 190 (FIG.13A, 13B), toothless zipper 200 (FIG. 14A, 14B) or combination of thesemeans (FIG. 10A, 10B, 11A, 11B) carried by longitudinal edge portions107 and 108 along the entire length of sheet 101.

Handle 19 of the overtube 11 can be grasped by an endoscopist and thedistal end portion 16 of overtube 11 can be pushed into the body cavityusing endoscope shaft 91 as a guide. Overtube distal end portion 16 canbe advanced so that distal end portion 16 of overtube 11 reachesendoscope tip 92 within the body cavity so overtube 11 can be viewedthrough the endoscope and then it is pulled back just a few centimetersto ensure that the distal end portion 16 of overtube 11 is situated justproximal to endoscope tip 92 within the body cavity.

At this point, inflatable positioning ring 22 at distal end portion 16of overtube 11 is inflated to secure the position of overtube 11 withinthe body cavity. This creates a seal between the external surface of theovertube 11 and the body cavity.

At this point, endoscope shaft 91 can be removed or replaced withanother endoscope, if desired, while overtube 11 is still within thebody cavity.

At this point, inflatable sealing bands 32 or 34 of overtube 11 can beinflated to secure the position of endoscope shaft 91 within overtube11. This creates a seal between the internal surface of the overtube 11and the endoscope shaft 91.

Distal end portion of the occlusion balloon catheter 80 can be insertedinto catheter passageway entrance port 65 on catheter passageway portprojection 64 and passed through catheter passageway and exit fromcatheter passageway exit port 61 at distal end portion 16 of overtube 11inside the body cavity. Then, inflatable occlusion balloon 84 at distalend portion of the occlusion balloon catheter 80 can be independentlypositioned distal to the distal end portion 16 of overtube 11 within thebody cavity, distal to the tip of the endoscope 92.

Then, an inflatable occlusion balloon 84 can be inflated to secure theposition of the occlusion balloon 84. This creates a seal between theocclusion balloon 84 and the body cavity.

As it is depicted in FIG. 16A, an examination compartment 95 can beformed around endoscope tip 92 within the gastrointestinal tract.Examination compartment 95 is formed when inflatable positioning ring22, inflatable sealing band 32 or 34 (FIG. 5 ), and occlusion balloon 84are all inflated, and the compartment is filled with air or water.

As it is depicted in FIG. 16A, the compartment 95 can be filled with airor water. The overtube 11 can further include a catheter passageway anda fluid/insufflation conduit (not shown) that terminates distally at twoopenings 61 and 42 at the distal end 18 of the overtube 11. Thefluid/insufflation conduit can be carried by overtube 11 and terminatesproximally at the quick connect fitting 140 at the handle 19 of theovertube 11 that connects the fluid/insufflation conduit catheter to anautomated control system 180. Fluid/insufflation conduit can be used toinflate or deflate examination compartment 95 with water or air.

As it is depicted in FIG. 16A inflated positioning ring 22 can beasymmetric. The inflated positioning ring 22 can be eccentric relativeto the longitudinal axis of overtube 11 in a way that inflatablepositioning ring 22 and overtube external surface 12 create internaltangent circles. The tangent point of these two circles can be atlongitudinal seam 51. This allows better sealing created by inflatablepositioning ring 22 within the gastrointestinal lumen and also createsan eccentric position for endoscope shaft 91 within the gastrointestinallumen. This eccentric position of endoscope shaft 91 within thegastrointestinal lumen provides an advantage in the maneuverability ofendoscope tip 92 within examination compartment 95 in thegastrointestinal lumen, particularly when overtube 11 is rotated.

The overtube 11 can carry a positioning ring inflation tube (not shown)that connects distally to inflatable positioning ring 22 and terminatesproximally to quick connect fitting 140 at the handle 19 of the overtube11 that can be used to inflate or deflate inflatable positioning ring22.

Examination compartment 95 can be enlarged or made smaller within thegastrointestinal tract by pulling or pushing the occlusion ballooncatheter 80, thereby moving occlusion balloon 84 independent of theovertube 11 and endoscope tip 92. This can be accomplished without theneed for deflating the occlusion balloon 84. Alternatively, occlusionballoon 84 can be deflated, repositioned, and re-inflated.

Examination compartment 95 can also be moved along the body cavity whenthe overtube 11, endoscope shaft 91 within overtube 11, and theocclusion balloon catheter 80 are all moved as a single unit in relationto the body. This can be accomplished without deflating occlusionballoon 84, positioning ring 22, or sealing band 32 or 34. This can beperformed for better visualization of the body cavity's various portionsor moving examination compartment 95 to the desired location.Alternatively, occlusion balloon 84, inflatable positioning ring 22, orinflatable sealing band 32 or 34 can be deflated, repositioned, andre-inflated, together or independently of one another.

After forming compartment 95 within the body cavity, the endoscope tip92 can be moved independently of the overtube or positioning ring withinexamination compartment 95 without the need for deflation of the sealingband 32 or 34. Alternatively, sealing bands 32 and 34 can be deflatedfor moving or repositioning endoscope tip 92 at the end of the overtube11.

Examination compartment 95 can be filled with air or water depending onthe procedure application using fluid catheter conduit 42, whichterminates in port 146 of the quick, connects fitting 140 (FIG. 3 ).

As it is depicted in FIGS. 16B-D, the examination compartment 95 can beused as stepping stone for access to the space beyond thegastrointestinal lumen through a puncture 96 within the compartment 95.The compartment 95, which is formed around endoscope tip 92, ispunctured using endoscopic tools, and the endoscope or other surgicalinstruments pass through the created opening 96 to access theextra-luminal space through the lumen of the gastrointestinal tract atthe level of compartment 95.

As it is depicted in FIG. 17A, examination compartment 95 can also belavaged while the endoscope shaft 91 is still within the compartment 95,using irrigation tube system 110 and irrigation/drainage port 111. Inthis case, the sealing band 34, located at the proximal end portion 14of the overtube 11, is inflated while the sealing band 32 is keptdeflated. Then, the irrigation tube system 110 can be connected throughirrigation tube connector 113 to irrigation/drainage port 111. Water orother fluid can be purged into and drained from examination compartment95 using irrigation/drainage port 111 and irrigation tube system 110while endoscope shaft 91 is still within overtube 11.

Alternatively, examination compartment 95 can be lavaged after removalof the endoscope shaft 91 from the overtube 11 with irrigation solutionor water using irrigation tube system 110 and irrigation/drainage port111 as it is depicted in FIG. 17B. In this figure, it is shown a capsystem 114, comprising a removable cap 115 and a string 116 that isconnected from one end to cap 115 and on the other end to handle 19 atproximal end portion 14 of overtube 11. Cap 115 can be used toreversibly seal proximal opening 17 of overtube 11. Cap 115 can closethe proximal opening 17 of overtube 11 when endoscope shaft 91 is not inovertube 11. As depicted in FIG. 17B, cap 115 can be connected toovertube 11 by a string 116. Those skilled in the arts can understandthat string 116 is for convenience only and not critical to theinvention. Cap 115 can be an independent feature or, alternatively, canbe attached to device 10 by any suitable means. When in use, afterplacement of overtube 11 and inflation of positioning ring 22 andocclusion balloon 84, the sealing bands 32 and 34 can be deflated, andthe endoscope 91 can be withdrawn from the overtube 11, and theirrigation tube system 110 can be connected through irrigation tubeconnector 113 to irrigation/drainage port 111. Water or other fluid canbe purged into and drained from examination compartment 95 usingirrigation/drainage port 111 and irrigation tube system 110. The cap 114can be placed at the proximal opening 17 of the overtube 11.Alternatively, examination compartment 95 can be lavaged after removalof the endoscope shaft 91 from the overtube 11 with irrigation solutionor water using irrigation tube system 110 without the need to useirrigation/drainage port 111 as it is depicted in FIG. 17C. Afterplacement of overtube 11 and inflation of positioning ring 22 andocclusion balloon 84, the sealing bands 32 and 34 can be deflated, andthe endoscope can be withdrawn from the overtube 11. Irrigation tubesystem 110 can be connected through irrigation tube connector 113directly to proximal opening 17 of overtube 11, while theirrigation/drainage port 111 is capped by cap 112. Water or other fluidcan be purged into and drained from examination compartment 95 usingovertube 11 and irrigation tube system 110, while endoscope shaft 91 isnot in overtube 11.

The overtube 11 also carries a set of tubes that terminates atmidportion 15 of the overtube 11. The suction conduit port 71, flushingport 75, and fenestration holes 77.

The secretions or air at the area proximal to inflated positioning ring22 can be aspirated using suction conduit port 71 at midportion 15 ofovertube 11.

The flushing port 75 can be used to flush water to clean the areaproximal to positioning ring 22. The fenestration hole/s can allow apassive passage of fluid, secretion, and gas from the lumen of thegastrointestinal tract proximal to the inflatable positioning ring 22 tothe lumen of the overtube for drainage of the body cavity.

The secretions or air at the area distal to the inflated occlusionballoon 84 can be aspirated using occlusion catheter suction tip 89,downstream of occlusion balloon 84.

After completion of the examination, the air or water within examinationcompartment 95 is drained via fluid/insufflation conduit port 42 orendoscope suction channel. Then, the inflated positioning ring 22,inflated sealing band 32 or 34, and inflated occlusion balloon 84 areall deflated, and overtube 11, occlusion balloon catheter 80 as well asendoscope shaft 91 can be removed independently of each other from thebody cavity.

The foregoing description and the drawing are illustrative of theinvention and are not to be taken as limiting. Still, other variants andrearrangements of structural parts are possible without departing fromthe spirit and scope of this invention and can readily presentthemselves to those skilled in the art.

As can also be understood by those skilled in the arts, the order of thesteps of the method described above is not critical. The spirit of theinvention and the method for employing it are found in the individualfeatures of the invention and their use, not the order in which they areused or presented herein; in fact, the user can elect to eliminatecertain steps.

The preceding merely illustrates the principles of the invention. Itwill be appreciated that those skilled in the art will be able to devisevarious arrangements which, although not explicitly described or shownherein, embody the principles of the invention and are included withinits spirit and scope. Furthermore, all examples and conditional languagerecited herein are principally intended to aid the reader inunderstanding the principles of the invention and the conceptscontributed by the inventors to further the art and are to be construedas being without limitation to such specifically recited examples andconditions.

Moreover, all statements herein reciting principles, aspects, andaspects of the invention, as well as specific examples thereof, areintended to encompass both structural and functional equivalentsthereof. Additionally, it is intended that such equivalents include bothcurrently known equivalents and equivalents developed in the future,i.e., any elements developed that perform the same function, regardlessof structure.

The scope of the present invention, therefore, is not intended to belimited to the exemplary aspects shown and described herein. Rather, thescope and spirit of the present invention are embodied by the appendedclaims.

We claim:
 1. A method for performing an endoscopic procedure comprisingthe steps of: placing an endoscope shaft within a body cavity at adesired examination point, the endoscope shaft having a proximal end,mid shaft and a distal end, the distal end terminating in an endoscopetip, wherein the endoscope tip is proximal to the desired examinationpoint; positioning a segment of a longitudinally opened overtube overthe endoscope mid shaft, wherein the overtube including a longitudinalreclosable seam along an entire length of the overtube, an innersurface, an outer surface, a proximal end and a distal end, apositioning ring adjacent the distal end on the outer surface, at leastone sealing band on the inner surface, and an independently positionableocclusion catheter terminating in an asymmetrical occlusion balloon; atleast one handle at the proximal end and on the outer surface forgrasping and manipulation of the overtube within the body cavity;closing the seam of the segment of the overtube positioned over theendoscope mid shaft to form a longitudinally closed overtube and movethe closed overtube over the endoscope shaft as guide within the bodycavity and repeat the closing and moving till the overtube reaches thedesired examination point; inflating the positioning ring to create aseal between the outer surface of the overtube and the body cavityproximal to the endoscope tip, wherein when inflated the positioningring expanded asymmetrically around the overtube; inflating the at leastone sealing band to create a seal between the internal surface of theovertube and endoscope shaft; passing the independently positionableocclusion catheter terminating in the asymmetrical occlusion balloonthrough a passageway along the overtube to enter the body cavity at theend of the overtube; manipulating the independently positionableocclusion catheter to a selected point within the body cavity distal tothe endoscope tip; inflating the occlusion catheter balloon to createseal between the occlusion catheter balloon and the body cavity; andcreating a sealed examination compartment between the positioning ring,the asymmetrical occlusion balloon and the sealing band surrounding thedistal end of the endoscope shaft.